When you are shopping for a Medicare plan, you are looking at plans that provide all your coverage in one bundled plan or supplemental coverage to the Original Medicare program that will cover gaps in Original Medicare.
You are not ‘required’ to sign up for additional coverage but there are many gaps in Original Medicare that if not covered may cost you down the road.
Medicare Supplement plans (also called Medigap plans) let you stay enrolled in Original Medicare Part A and Part B, and cover the expenses that Original Medicare A and B itself will not, such as emergency medical coverage when you’re traveling outside of the U.S., deductibles, coinsurances/copays and other out-of-pocket expenses. These plans have up-front costs but the most commonly purchased plans have limited other expenses when you use services.
This Medicare Supplement Comparison chart below is a useful tool for comparing different Medigap Plans to understand what each plan covers. Each plan is federally standardized so all insurance carriers who offer these “plans” provide coverage for the same healthcare services based on the government guidelines.
| Plan A | Plan B | Plan C | Plan D | Plan F* | Plan G* | Plan K | Plan L | Plan M | Plan N | |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | Y | Y | Y | Y | Y | Y | 50% | 75% | Y | Y |
| Part B coinsurance or copayment | Y | Y | Y | Y | Y | Y | 50% | 75% | Y | Y*** |
| Blood (first 3 pints) | Y | Y | Y | Y | Y | Y | 50% | 75% | Y | Y |
| Part A hospice care coinsurance or copayment | Y | Y | Y | Y | Y | Y | 50% | 75% | Y | Y |
| Skilled nursing facility care coinsurance | — | – | Y | Y | Y | Y | 50% | 75% | Y | Y |
| Part A deductible | — | Y | Y | Y | Y | Y | 50% | 75% | 50% | Y |
| Part B deductible | — | — | Y | – | Y | – | — | – | – | – |
| Part B excess charge | — | – | – | – | Y | Y | – | — | – | – |
| Foreign travel exchange (up to plan limits) | — | — | 80% | 80% | 80% | 80% | — | – | 80% | 80% |
| Out-of-pocket limit** | N/A | N/A | N/A | N/A | N/A | N/A | $6,940 in 2023 | $3,470 in 2023 | N/A | N/A |
Notes: Y = Yes, — = Not Covered
* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,700 in 2023 before your policy pays anything. (Plans C and F aren’t available to people who were newly eligible for Medicare on or after January 1, 2020.)
** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.
Be sure to sign up when you first become eligible to get a Guaranteed Issue plan and avoid underwriting
“Guaranteed issue” means that the insurance company guarantees that it will issue you a policy at the best rate without any underwriting for health or preexisting conditions. You cannot be denied a policy.
Bear in mind that guaranteed issue only applies to Medicare Supplement plans (aka Medigap) where you get supplemental Medicare insurance from a private insurance company. This concept doesn’t apply to Medicare Advantage (which is always available to anyone who needs coverage (during applicable enrollment windows)).
As with all things Medicare there are windows of time when you can sign up or make changes. To qualify for a guaranteed issue Medicare supplement plan, you must enroll within the first six months after signing up for Part B. Or if you have a Special Enrollment Period (SEP) that qualifies you for enrollment, you must sign up then. (Note not all Special Enrollment circumstances qualify for a guaranteed issue period.)
Decide whether to get Plan G, Plan N or one of the other plans
As you shop for a Medicare Supplement Plan, you will learn that there are 10 different government-standardized plans. The two most popular by far are Medicare Supplement Plan G and Medicare Supplement Plan N.
Neither Plan G nor Plan N covers your Part B deductible, which is $226 in 2023. But once you have met that deductible for the year, your plan will pay the rest.
Both Plan G and Plan N policies cover many of the costs that Original Medicare doesn’t. For instance, they will cover:
- Blood (first three pints you receive)
- Foreign travel emergency care (may vary by policy)
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance
- Part A hospice care coinsurance or copayment
- Skilled nursing facility coinsurance
- Your Medicare Part A deductible ($1,600 in 2023)
Note that Supplement Plan G policies cost more and provide more extensive coverage than Plan N policies do. Plan N policies will not cover certain add-on charges that health care providers can add to your bill.
In addition, Plan N policies do not cover copays for office visits. So read the fine print. You could learn, for example, that your Plan N policy will only pay for your emergency room visit if you are admitted as an inpatient; if you are not, you could be hit with a hefty bill for your visit.
The bottom line is, to learn everything you can about your policy type before you enroll and get some expert guidance.
Be sure to ask about a household discount
When you sign up for a Medicare Supplement Plan, you could get a household discount of up to 12-15%. Learn how the discount might apply to you.
And Check Out this Interactive Comparison Tool from the Medicare Experts at CoverRight.com
See 20+ Medicare Supplement Plans Comparisons on the CoverRight platform. This is a customized comparison you complete based on your personal data.
We hope that the advice in today’s article will help you use that comparison chart to understand the different plans, consider all the “moving parts” and pick the plan that will cover your healthcare needs.
And Remember, CoverRight Medicare Advisors Are Ready to Guide You
To Learn More, Contact a CoverRight Medicare Expert Today!
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CoverRight is on a mission to make the Medicare plan selection process easy to understand. We are here to help you find the best Medicare plans suited to your specific situation. Try our self-guided Medicare quiz to see for yourself.
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